Yang Qintai, Li Hui, Wu Weijun, Huang Xuekun, Tu Bo, Ma Yukun, Deng Huiyi, Li Meijiao, He Hongfeng, Li Can, Yang Yongqi
Department of Otorhinolaryngology - Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China,
Department of Otorhinolaryngology - Head and Neck Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
Ther Clin Risk Manag. 2018 Aug 24;14:1507-1513. doi: 10.2147/TCRM.S170548. eCollection 2018.
The effect of continuous positive airway pressure (CPAP) on nasal symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) remains controversial. In addition, possible mechanism(s) remains unclear.
To examine whether CPAP contributes to the onset and exacerbation of allergic rhinitis (AR) in OSAHS patients based on patient-reported changes in nasal symptoms with and without CPAP therapy and the detection of house dust mites (HDMs) in CPAP filters and household environments.
In a cohort of OSAHS patients, 350 patients who were undergoing CPAP therapy and 100 patients who declined CPAP therapy were retrospectively analyzed. These patients were contacted by telephone and asked to compare their nasal symptoms before and after CPAP therapy. HDMs in air conditioner and CPAP device filters and in household dust samples were detected using enzyme-linked immunosorbent assays.
The prevalence of AR was higher in the CPAP group vs the non-CPAP group (15.8% vs 7.0%, respectively; = 0.025). The onset of AR among the OSAHS patients with no previous history of AR significantly increased within the first year of CPAP therapy compared with the control group (5.7% vs 0%, respectively; = 0.031). Meanwhile, the patients with a history of AR were more likely to experience exacerbated rhinitis symptoms within the second year of treatment compared with the control group (7.5% vs 0%, respectively; = 0.005). There was no significant difference in HDM concentrations between the CPAP and air conditioner filters, yet the concentrations in both the filters were higher than the concentrations in the bedroom dust samples (all < 0.05).
CPAP is associated with the onset and exacerbation of AR in OSAHS patients. Long-term exposure to high concentrations of HDM allergens may be a significant factor.
持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者鼻部症状的影响仍存在争议。此外，其可能的机制尚不清楚。
基于患者报告的有无CPAP治疗时鼻部症状的变化以及CPAP过滤器和家庭环境中屋尘螨（HDM）的检测，研究CPAP是否会导致OSAHS患者发生变应性鼻炎（AR）及使其加重。
对一组OSAHS患者进行回顾性分析，其中350例正在接受CPAP治疗，100例拒绝CPAP治疗。通过电话联系这些患者，要求他们比较CPAP治疗前后的鼻部症状。采用酶联免疫吸附测定法检测空调和CPAP设备过滤器以及家庭灰尘样本中的HDM。
CPAP组AR的患病率高于非CPAP组（分别为15.8%和7.0%；P = 0.025）。与对照组相比，既往无AR病史的OSAHS患者在CPAP治疗的第一年内AR的发生率显著增加（分别为5.7%和0%；P = 0.031）。同时，与对照组相比，有AR病史的患者在治疗的第二年更易出现鼻炎症状加重（分别为7.5%和0%；P = 0.005）。CPAP过滤器和空调过滤器中的HDM浓度无显著差异，但两者的浓度均高于卧室灰尘样本中的浓度（均P < 0.05）。
CPAP与OSAHS患者AR的发生及加重有关。长期暴露于高浓度的HDM变应原可能是一个重要因素。
